Deep Rock Chiropractic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

DEEP ROCK CHIROPRACTIC PC

Practice address

1900 Division St W Unit 7
Bemidji, MN 56601-6397

Phone

(218) 751-5910

Fax

(218) 444-5911

NPI assigned

Dec 20, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Joseph Wade Edlund, DC

Title

Owner

Phone

(218) 751-5910

Specialties & licenses 1

Addresses

Other names 1

• DEEP ROCK CHIROPRACTIC PC Other name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Andrew McDonald, DC

  • Chiropractor
  • Bemidji, MN
  • NPI 1972162550
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639958400000",
    "number": "1851051742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 DIVISION ST W UNIT 7",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566016397",
            "telephone_number": "218-751-5910",
            "fax_number": "218-444-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 DIVISION ST W UNIT 7",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566016397",
            "telephone_number": "218-751-5910",
            "fax_number": "218-444-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEP ROCK CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A",
        "authorized_official_last_name": "EDLUND",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-751-5910",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DEEP ROCK CHIROPRACTIC PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Darrell and Penny Bohlman
• Corinne Dauksavage, ATC
• Bobbie Jo Davis
• Trica Gene De la Hunt, NP
• Austin Decock, MS, LPCC
• Daniel Peter Dekrey, MD
• Pamela L Delancey, MS, ATC
• Rylie Jayne Demers
• Dermatology Professionals, PA
• Destiny Enterprises, LLC

• Chiropractor in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.